Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Coronary artery calcium testing can reveal plaque in arteries, but is underused

nytimes.com

Post reply on HN
Print view View original

191–197 of 197 posts

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#191

Post by LorenPechtel »

Theodores wrote: post #188
LorenPechtel wrote: post #174

Earlier quoted context omitted.

Upsell? It's never been a matter of discussion. Doctors orders some standard bloodwork every year. HDL and LDL are part of it.

We don't even have the phrase 'bloodwork' in the UK. Also, in the UK, you can go to the doctor regularly for a checkup to never get this 'bloodwork' thing you Americans speak of. I have never had any done myself, all I get is my iron level when I donate blood, and I only ask about that after curiosity. Healthcare is very different in America and I am not seeing the benefits of yearly 'bloodwork', it must be an upsell…

Multiple things are much better caught earlier. Off the top of my head:

Catch the elevated A1c before it does any damage, or get diagnosed from a hypoglycemic episode?? (By which point a lot of damage has been done.)

Catch the elevated TSH and supplement before there are any symptoms, or wait until the patient presents with hypothyroid? Note that the patient will have been through a fair amount of blah before the diagnosis is made. And thyroid hormones are very dose sensitive and it's a couple of months to stabilize on a new dose, so bringing the patient back to normal can take quite a while. US approach, my wife's TSH was high, they put her on some thyroid hormone, no symptoms of hypothyroid and no rush to dial in the dose because it's still within the body's ability to compensate and thus causes no problem.

And the subject of this thread, statins. Again, much, much better caught before it does damage.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#192

Post by 31carmichael »

JeremyNT wrote: post #146
apothegm wrote: post #5

Earlier quoted context omitted.

CAC is the right test for people who already have identified that they have major risk factors such as metabolic syndrome/T2D, high cholesterol, etc. It identifies whether heart disease has already advanced enough that the risk factor has become a risk. Some of the tests you list (like A1C) are baseline things everyone should get checked every year. Agreed that the others could provide value for those who want to kno…

I've had high-ish LDL for ages and diet alone couldn't knock it all the way down. It's only the CAC score that provided me with peace of mind that I didn't need to reach for statins. The way I view this is that, if you can get more information, why wouldn't you? Cost of course, and I understand why insurance might not cover the procedure, but anybody of a certain age with any risk factors who is in a position to affo…

I have a CAC score of zero (no calcified plaque) and I take both a statin and ezetimibe to lower my LDL and ApoB. I disagree with your assessment that your CAC score along means that I statin wouldn't lower your risk.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#193

Post by lokrian »

klipklop wrote: post #9

What I always wondered is if I get this test done, what would I even do with the results? If my arteries are already clogged, etc. Can this plaque be reversed?

At least one clinical trial is underway for a drug that can remove the plaques: https://www.lifespan.io/news/cyclarity-launches-human-trial-... But yeah, we badly need more companies doing more research in this space.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#194

Post by pardner »

brandonb wrote: post #3

Before getting a CAC scan, I'd probably do these tests first: * ApoB - about 20% of people with normal cholesterol results will have abnormal ApoB, and be at risk of heart disease. * Lp(a) - the strongest hereditary risk factor for heart disease. * hs-CRP - inflammation roughly doubles your risk of heart disease * HbA1c - insulin resistance is a risk factor for just about everything. * eGFR - estimates the volume of…

Saw your link, did your test and here's my feedback.

No "share" or "download" button in the app? Sure, "apps are cool" and all that - but what about folks who want to archive or share their health data? AFAIK literally no provision to share all those nifty biomarkers with my doctor (except many, many screenshots)?

Nowhere in the "how to get blood test" email instructions does it bother to mention a urine sample will also be needed. Kinda useful to know if you should not pee right before heading to the lab.

Re: Coronary artery calcium testing can reveal plaque in arteries, but is underused

#195

Post by gcanyon »

l8rlump wrote: post #186
gcanyon wrote: post #107

Earlier quoted context omitted.

I know my cholesterol numbers going back almost twenty years, over something like 15 tests. This is because that first test around 2007 showed my HDL was ridiculously low. So I took steps to modify it, and tested again (and again...) to see how it was progressing.

How can you increase your HDL?

N=1, but: I read that carbs lower HDL, and I was eating a very carb-heavy diet.

So over about two months I switched to an informal low-carb diet. e.g. I stopped drinking milk, I ate Carl's Jr. six-dollar burgers as lettuce wraps for lunch, and sometimes just roast beef and mayo.

Over three months I lost something like 30 pounds, hitting a body fat percentage around 12% -- this wasn't the goal, but FWIW.

My HDL before was 17, after those three months, 25.

Then I added in various forms of exercise and got it up to about 55.

I've since engaged in various diets, and levels of exercise -- although I've never gone back to the original diet where whole meals consisted of a quart of ovaltine. My HDL has never dropped below 40, nor been higher than 65.

Post reply on HN